Dental Hygiene Department STUDENT COURSE DOCUMENT. DEN 2400L Principles of Dental Hygiene Care IV

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1 Dental Hygiene Department STUDENT COURSE DOCUMENT COURSE CODE & TITLE: DEN 2400L Principles of Dental Hygiene Care IV TERM: Spring 2017 CO-COORDINATORS: SEMINAR FACULTY: CONTACT INFORMATION: OFFICE HOURS: LABORATORY HOURS: Maria-Elena Bilello, RDH - Clinic Shantel Childs-Williams, RDH - Radiology Christine Macarelli, MS, RDH Maria-Elena Bilello (718) mbilello@citytech.cuny.edu Shantel Childs-Williams (718) SChilds@citytech.cuny.edu Maria-Elena Bilello RDH Monday 7:30AM 8:30AM Tuesday 4:00PM-5:00PM Shantel Childs-Williams RDH TBA 12 per week CREDITS: 5 PREREQUISITRE: DEN 2300, DEN2311, DEN2315, DEN2318, COREQUISITES: DEN 2413 REQUIRED TEXTBOOKS: CLINICAL PRACTICE OF THE DENTAL HYGIENIST 11 th edition, Esther M. Wilkins ISBN: ISBN-13: Lippincott; Williams & Wilkins 1

2 Clinical Course Description Continuation of the principles and techniques involved in the practice of dental hygiene as introduced in DEN 1100 DEN 1200 and DEN Using the knowledge and skills acquired in this and previous semesters, the student will assess each patient assigned, formulate a treatment plan, complete treatment and evaluate results. Seminar Course Description DEN 2400 seminar presents the didactic material, which correlates with the clinical experience, provided in DEN 2400L. The Clinical Faculty serves as group facilitators who assist the students in developing an awareness of and appreciation for the concepts, topics, and procedures related to the Dental Hygiene profession. College Grading Scale Evaluation Procedures A A B B B C C Below 70 Fail. Course Assessment Method: As per the department guidelines, All the DEN Clinical courses have 2 components. Each component must be passed independently. DEN2400 the passing grades: Clinical Component (A) is a cumulative average of 75. Didactic (seminar) Component (B) is a cumulative exam average of 70. The Clinical grading criterion is based upon a score of 75 which is required to pass the dental hygiene CDCA exam. The calculation of the DEN2400 grade will be as follows: Component A (numerical grade) x 60% Component B (numerical grade) x 40% Final Grade Component A (Clinical Component) Daily Clinical Evaluation Mock Board Exam Radiology Skills E-Portfolio Resume Assignment 15% 15% 20% 5% 5% Component B (Didactic Component) Problem Based Learning (3 sessions) Written Examinations (2) Exam 1 Exam 2 15% 12% 13%

3 Course Policies: In accordance with the Dental Hygiene Department policy, all students are responsible to read the student manual and to be familiar with the policies on attendance, punctuality, attire, pregnancy and professionalism. A. ATTENDANCE/LATENESS REQUIREMENTS As stated in the College catalogue, a college department may use the attendance/lateness criteria stated in the Colleges catalogue or the College department may create and state their own attendance/lateness policy for the department courses. DEN 2400L clinical sessions = 2 absences or 2 PNP s or a combination of 1 absence and 1 Patient Not Present (PNP). Students will be considered late for clinic if they are not dressed in the prescribed clinical attire and their cubicle is not prepared to receive a patient at the start of their clinic session. Therefore students should plan to be in the clinic at least 15 minutes prior to the start of the clinical session to disinfect and set-up the cubicle. Any student who is not present in clinic 15 minutes prior to the scheduled seating time of a patient will be marked late. Attendance is the responsibility of the student and clinical practice requires the student s presence in both the clinic. Students who are chronically late will incur point deductions off their final grade. Habitual Lateness in DEN2400L: 4 clinic sessions = - 1 point off final course grade 5 to 7 clinic sessions = - 5 points off final course grade 8 or more clinic sessions = - 10 points off final course grade (Under the category of professionalism). New York City College of Technology Policy on Academic Integrity Students and all others who work with information, ideas, texts, images, music, inventions, and other intellectual property owe their audience and sources accuracy and honesty in using, crediting, and citing sources. As a community of intellectual and professional workers, the College recognizes its responsibility for providing instruction in information literacy and academic integrity, offering models of good practice, and responding vigilantly and appropriately to infraction s of academic integrity. Accordingly, academic dishonesty is prohibited in The City University of New York and at New York City College of Technology and is punishable by penalties, including failing grades, suspension, and expulsion. The complete text of the College policy on Academic Integrity may be found in the catalog. EXAMINATIONS Clinical skills examination will be announced & given during the semester. The student will be responsible for providing an appropriate patient. Seminar examinations are listed in the seminar outline Dental Hygiene Department Policy on Retesting No student in any dental hygiene course will be retested in any examination for any reason. A failing grade on a quiz/examination will remain and be averaged with all other course grades. 3

4 B. PROFESSIONALISM As per the Dental Hygiene Manual the following items will be taken into consideration when determining the final grade: rapport with instructors, peer & patients punctuality personal hygiene, appropriate attire proper care and use of equipment ethical management & treatment of patients and their charts adherence to established procedure & protocols other behaviors determined to be either unethical or unprofessional such as stealing or cheating. 10 points will be deducted from the final grade for noncompliance of the above standards of professionalism. In the event that this point value deduction results in a grade below 75, the student will NOT be allowed to progress & will follow the dental hygiene department course repeat policy as specified in the student manual. C. COURSE REQUIREMENTS All required competencies for DEN 2300/2300L must be satisfactorily demonstrated (>75%) immediately preceding enrollment in this course. Passing DEN 2300/2300L in the semester immediately preceding this course will serve to satisfy this requirement. If for any reason, there is a break in continuity of consecutive semester attendance, a separate evaluation process for competencies will be required and enrollment will then only be permitted on a space available basis. REQUIREMENTS: 1. Current CPR certification 2. Annual Medical Examination 3. Submission of eportfolio assignment 4. Satisfactory performance of clinical process evaluations 5. Providing dental hygiene services to patients of the NYCCT Dental Hygiene Clinic 6. Completion of all radiology requirements. 7. Attendance at guest lecture events. 8. Completing all seminar requirements The DEN 2400L has a beginning course date and an end of course date. Students are responsible to complete all their clinical requirements by the end of the course. All incomplete requirements will be reflected in the final grade as a deduction of 10 points per requirement. In the event that this point value deduction results in a grade below 75, the student will NOT be allowed to progress & will follow the dental hygiene department course repeat policy as specified in the student manual. D. ASSIGNMENT OF CINIC PATIENTS: The office manager tries to schedule all patient appointments at least one (1) week in advance. If a student does not wish to be assigned a clinic patient on a specific date, it is the student s responsibility to inform the office manager of the date(s) and to verify this information by writing DNA (do not assign) in the clinic appointment book. 4

5 Once an appointment has been scheduled, only the office manager/clinic coordinator has the authority to re-assign that patient. Clinic responsibility and Patient No Show Policy: When a student s patient does not show (PNP) for their dental hygiene appointment, the student is required to remain in clinic for 2.5 hours & NOT permitted to leave clinic without faculty permission. Students will be required to look for a patient who needs clinical services such as radiographs, alginate impressions, sealants, periodontal dressing etc. In the event the student cannot secure a patient, the student will be assigned by the group instructor to assist at the reception desk, central supply area, or to assist fellow students. Learning Experience: A. PATIENT TREATMENT PROCEDURES Patient treatment procedures, as stated below, will be evaluated during clinical sessions by clinical instructors using the established clinical evaluation criteria. a. Medical History Review: all clinic patients (new medical history required for every patient every 3 years) b. Intra/Extra Oral Examination: all clinic patients c. Dental Charting: In the paper chart: Initial visit - charting of entire dentition Recall/Revisit visits - update as necessary In electronic charts: Initial visit - charting of entire dentition Recall/Revisit visits - update as necessary d. Periodontal Charting: In the paper and digital chart, Initial exams - record probing depths of 4mm or greater for all quadrants: 1. complete all information requested 2. patients with recession (clinical attachment loss) ALL probing depths must be recorded. Recall patients review the Gingival/Mucogingival line & record probing depths of 4mm or greater for all quadrants. patients with recession (clinical attachment loss) ALL 6 probe depths readings per tooth must be recorded. In the electronic chart, at Initial and baseline full mouth every 3 years in conjunction with new medical history. Record all 6 readings per tooth. e. Treatment Planning and Implementation for DH services: Radiographs when indicated. Patient referrals as indicated. Scaling and Root Planning as indicated. Polishing Fluoride Treatment as per assessment B. CLINICAL PATIENT CASE TYPE/VALUE REQUIREMENTS Students are required to: Keep an accurate, up to date appointment book with patient contact information. Provide an adult patient for each clinical session. 5

6 Provide treatment for patients with varying degrees of periodontal disease. Record the information required in the Verification sheet. Handle patient charts as per the department procedures. The following is the minimal criteria, which must be met, in order to successfully complete DEN2400: Four (4) completed cases on patients with any periodontal classification (I through IV) and HEAVY CALCULUS DEPOSITS as defined in the student manual. Eight (8) completed cases on patients with any periodontal classification (I through IV) & MEDIUM CALCULUS DEPOSITS as defined in the student manual Manage (3) Pediatric dental patients for oral hygiene procedures. If applicable, evaluation of the Arestin placement sites from DEN 2300 course C. REQUIRED 2400 CLINIC EVALUATIONS a. ARESTIN: This year , all Arestin was placed in DEN 2300 during the Fall 2016 semester. Students who placed Arestin and evaluated the 8 sites have completed this requirement. o Students who placed Arestin, but did not evaluate the patients in the Fall 2016 semester will have to contact their patients and re-evaluate the 8 sites where Arestin was placed on a clinic day when Dr. Archer is available. This requirement must be completed in order to graduate June o Dr. Archer will verify the sites and sign-off the Arestin requirement is complete and will inform Prof. Bilello. In the event you are unable to contact the patient from the Fall 2016 semester and therefore cannot evaluate the patient, then arrangements must be made to secure another patient and place and evaluate the Arestin on this patient under the supervision of Dr. Archer. o Arestin carpules will be given to students based upon the supply of Arestin, the DH department has remaining. If the number of carpules needed to be placed by students exceeds the supply of carpules we have remaining then students who need to complete this requirement will divide the cost of purchasing additional Arestin to complete this requirement. o The DH program and Orapharma (Arestin) will provide free of charge 8 carpules /student for the academic year. Everyone who placed Arestin has received their 8 free carpules. Students will: 1. Obtain informed consent and have the Arestin consent form signed. 2. Signed consent forms are placed in Dr. Archer s mailbox at the end of the clinic session. 3. Record next to your name in the excel sheet the patient information requested and the location of Arestin placement as well as pre and post treatment pocket depths. The excel sheet is located in the Clinic computer in Clinic A. 4. Students will receive credit only when the patient returns for re-evaluation of the Arestin therapy sites. 5. If your patient fails to return, you will not be given credit for the DEN 2300 /DEN 2400 course requirement and this will be reflected as an I grade for DEN 2400 and will therefore affect your ability to 6

7 graduate in June b. IMPRESSIONS: demonstrate clinical competency on a minimum of three (3) patients & three (3) acceptable complete sets. c. PEDO PATIENTS: demonstrate clinical competency working with three (3) patients under the age of 12 years. d. PERIO DRESSING: demonstrate clinical competency on two (2) sextant application on two (2) different patients (may use a classmate). e. PROPHY-JET: demonstrate clinical competency on two (2) patients. Patients who have 2 quadrants of moderate to heavy stain will satisfy the requirement and if 4 quadrants of moderate or heavy stain are present than 2 students may share the patient case. (2quadrants each). Patients undergoing orthodontic treatment will be seen by 1 student. f. SEALANTS: demonstrate clinical competency using both isolation techniques to place a sealant on four (4) patients Two (2) with COTTON ROLL ISOLATION on children between the ages of 7 yrs. 17 yrs. ONLY Two (2) with RUBBER DAM on adult patients g. RADIOGRAPHS: a. 6 BWS 3 film based & 3 digital 3 of which must be exposed by mid-semester 2 film based & 1 digital 3 film based BWS must be exposed using paper bite-wing tabs b. 4 FMS 2 film based & 2 digital 2 of which must be exposed by mid-semester & must be on clinic patients 1 film based & 1 digital c. 3 Panoramic digital radiographs Clinic patients ONLY (demonstrate competency working independently). 1 Panorex must be printed and all landmarks identified ALL RADIOGRAPHS MUST BE EXPOSED AND REVIEWED ON CLINIC PATIENTS. h. RUBBER DAM/COTTON ROLL & DRY ANGLE ISOLATION: demonstrate clinical competency using both isolation techniques to place a sealant: 2 rubber dam isolations 2 cotton roll/dry angle isolations i. INJECTIONS: 3 Injections (any of the 12 injections required by NYS certification standards) are to be demonstrated and signed off by instructor. Failure to demonstrate will result in 5 points off final clinic grade. 7

8 New York State Dental Hygiene Restricted Local Infiltration Anesthesia/Nitrous Oxide Analgesia Certification This certification training is offered to students who are registered in the DEN 2400 course. The Dental Hygiene Restricted Local Infiltration Anesthesia/Nitrous Oxide Analgesia Certification is offered as a separate entity within this DEN 2400 course and is not required for the completion of this course nor eligibility for graduation from the Dental Hygiene program. A student will meet the criteria for completion of the dental hygiene AAS degree without this certification. Students who do not participate in this certification training, will meet with the DEN 2400 coordinator to establish scheduled clinical sessions in which they will provide patient care. Students who miss one portion of the certification training whether it is the administration of local infiltration anesthesia or the administration and monitoring of nitrous oxide analgesia will not receive a completion certificate from the department and will be required to obtain New York State certification on their own and at their own expense after graduation from the dental hygiene program. As per the Dental Hygiene department guidelines, students who are pregnant during the time when this certification training is offered are not eligible to participate in this certification process. They will be invited to complete their training as a Registered Dental Hygienist at a continuing education certification course at their own expense. Requirements of NYS Certification: Completion of state recommended hours of independent study. Completion of on-site didactic instruction for both local infiltration and nitrous oxide administration. o The didactic and clinical portions include all areas of instruction as outlined by New York State Department of Education, Office of the Professions. o Obtaining a passing grade of 70% or higher at the completion of both didactic and clinical components. Local infiltration testing includes a pretest and final test, the average of these 2 examinations must be 70% or higher. Students will not be recommended for certification who are not able to complete both components of the certification preparation. DEN2400L students who are not eligible for certification while in the dental hygiene program are encouraged to attend the didactic instruction for the administration and monitoring of local infiltration anesthesia/nitrous oxide analgesia as material from these lectures may be included in the dental hygiene national board examination. 8

9 DEN 2400L Course Objectives Course Objectives for Clinic and Seminar DEN 2400L is a continuation of the principles and techniques involved in the practice of dental hygiene. Incorporating the knowledge and skills acquired in the previous semesters, and in conjunction with the knowledge and skills obtained in this course, the student will be able to assess the patient s needs and implement an appropriate plan of care. At the completion of this course, the dental hygiene student is expected to: 1. Construct and implement an appropriate plan of care for patients. (PC1, PC2, PC3, PC4, PC5) 2. Understand the oral hygiene needs and services required by children, adolescence, adults, older adults and special needs patients. (PC1, PC2, PC3, PC4, PC5) 3. Take the required professional licensing examinations for Dental Hygiene. 4. Perform those duties expected of an entry level dental hygiene practitioner. (PC1, PC2, PC3, PC4, PC5 and C1, C2, C3, C4, C5, C6, C7) 5. Recognize and Report child abuse, maltreatment or neglect as a mandated reporter. (HP6, C2) 6. Understand and implement the infection control standards. (PC1, PC2, PC3, PC4, PC5) During this course, student will continually develop the skills for patient assessment, treatment planning, periodontal instrumentation and expanded dental hygiene functions. Please note that the number of hours per week the student must spend developing these clinical skills is specified in ADA Accreditation guidelines. If the student fails to meet these minimum requirements, he/she cannot advance. Seminar Course Objective: At the completion of this course, the dental hygiene student is expected to possess the knowledge to assess, diagnose, plan, implement and evaluate treatment for adult patients with an individualized care plan. The goal is to integrate the didactic knowledge of this profession into the clinical practice of Dental Hygiene. This course will utilize several approaches to teaching including but not limited to Blackboard; PowerPoint; group discussions; role-play and lecture in order to accomplish the stated objectives. Teaching Strategies Problem-based learning (PBL) will be implemented for some of the didactic sessions of this class to engage the students in active learning patterns which build problem-solving skills, confidence and foster teamwork. Students will be assigned to small teams and given a series of tasks or problems to complete. The students will draw on prior knowledge, critical thinking skills and team directed research to investigate and resolve each task or problem. The tasks or problems will be linked to guiding questions and focus on the application of the dental hygiene process of care. Members of the group will cooperatively interact by sharing thoughts, responsibilities and decision-making to reach consensus on a common desired outcome. Team activities will be managed through team assigned responsibilities. Problem-based Learning Goals 1. To foster a self-directed environment for students' resolution of a task/problem related to the care of patients presenting with chronic periodontal disease and related oral conditions. 2. To foster a cooperative team-based environment that may be applied to healthcare practice. 9

10 3. To foster critical thinking and problem-solving skills related to patient care. 4. To strengthen student's confidence in identifying, care planning and measuring outcomes for patients presenting with chronic periodontal disease and related oral conditions. Problem-Based Learning (PBL) Students will work in assigned learning teams throughout the semester. The team assignments will remain for the entire semester; however, the team roles (leader, recorder, & reporter) will change with the start of each new PBL module. Please refer to the PBL tab on BB for a detailed description of team roles. PBL Sessions cannot be made up. Failure to attend/participate will result in a grade of zero. Pre-session Assignment for PBL sessions: Pre-session assignment(s) will be assigned and are to be completed prior to the class. They may include but are not limited to writing responses to: Unit Objectives Assigned Readings Review of Power Point Presentations on the topic Quizzes Videos Problem Based Learning Class Session Day of class students will immediately assemble into their learning teams. Students will come prepared with class session assignment printed off and with necessary textbooks/assigned reading materials. S t u d e n t s are encouraged to bring electronic devices for internet searches Teams will have a team leader, team recorder, and team reporter Teams will have approximately minutes to work through the in-class assignment The remainder class time will be for teams to report their findings to their classmates (each team will have approximately 5-7 minutes to report their findings) Instructor will collect documents at the end of the session Students Post Class Session: Students are required to complete a peer evaluation by the next day at 11:30 pm (peer evaluations are located under "Week by Week" tab on BB under the PBL activity for that week.) for each team member at the closing of each PBL activity. Failure to submit a peer evaluation will result in points being deducted. See attached grading rubric for unit assignments. Evaluations are CONFIDENTIAL!! Evaluation of student performance for PBL activities/assignments will be measured by the course instructor and peer evaluation. Please refer to blackboard for link to grading rubric and peer evaluation 10

11 The Responsibility for Each Team Role is as Follows: Team R les Resp nsibilities TeamLea er Ensuresthattheteamfocusesontask Maintainsacooperativelearning environment Ensurestheteamkeepswithinthe timeframeforpresentationtothe class Coor inatesnewteamrolesforthe subsequentmo uleatthecompletion ofthecurrentmo ule Postteamconsensus/finalresponses to iscussionboar ifapplicable NoteTaker/Recor er TimeKeeper Keepsalogofthegroups activities,assignments& ecisions inclu ingassigne teamroles Takesnotes uringclassactivities Helpsthegroupstayontaskan remin sthegrouplea ertowork efficiently Helpsthegroupstayontaskan remin sthegrouplea ertowork efficiently Reporter Sharesthegroupsoutcomes& processwiththeclass 11

12 Seminar Topics: Unit- The Child Dental Patient and Children with Developmental Disabilities Explain the significance of the baby-wellness visit (C1) Discuss the behavior modification techniques used in dentistry (C4, PC3) Explain bottle-weaning procedures (C4) Discuss the prevention of Early Childhood Caries (C3, C4, HP2, HP4, HP5) Explain the oral hygiene needs of the primary dentition Explain the oral hygiene needs of the transitional dentition ( C 4, P C 1, P C 2, P C 3, P C 4, P C 5 ) Explain the oral hygiene needs of the permanent dentition (C4, P C 1, P C 2, P C 3, P C 4, P C 5 ) Discuss the management of children with developmental disabilities in the dental environment (C4) Gen Ed SLO s: Critical Thinking, Information Literacy, Reading Unit- Recognition and Reporting Child Abuse and Neglect Define what constitutes abuse, maltreatment, and neglect according to NYS Family Court and Social Service Law (complete on line course and review ppt in Blackboard) Describe situations in which mandated reporters must report suspected cases of child abuse or maltreatment (C2) Describe what constitutes reasonable cause to suspect that a child has been abused or maltreated (C2) Describe the legal protections afforded reporters and the consequences for failing to report (C2) Distinguish among various behavioral and environmental characteristics of abusive parents or caregivers (C4) Identify physical and behavioral indicators of physical abuse (C4) Identify physical and behavioral indicators of maltreatment and neglect (C4) Identify physical and behavioral indicators of sexual abuse (C4) Gen Ed SLO s: Critical Thinking, Information Literacy, Reading Unit - Pulmonary Disease Describe the following medical conditions: Asthma, Chronic Obstructive Pulmonary Disease (COPD), Tuberculosis (C4) Explain the etiologies of these medial conditions (C4) Identify medications prescribed to treat pulmonary diseases (C4) Discuss the dental hygiene treatment plan modifications that are necessary for each medical condition discussed in this unit. (C10, PC1, PC2, PC3, PC4, PC5) Gen Ed SLO s: Critical Thinking, Information Literacy, Reading, Integrative Learning 1

13 Unit - Patients with Physical Limitations Describe the following medical conditions: Parkinson Disease, Multiple Sclerosis, Spinal Cord Injuries, and Cerebral Vascular Accident (C4; HP2, PC1; PC2; PC3; PC4: PC5) Describe the following medical conditions: Cerebral Palsy and Muscular Dystrophy which begin in childhood (C4, PC1, PC2, PC3, PC4, PC5) Discuss the etiologies of these medical conditions (C4) Explain the type of medications that these individuals are prescribed to manage their medical problem (C3, C4) Discuss the dental hygiene treatment plan modification that are necessary for each medical condition discussed in this unit ( C10, PC1;PC2; PC3; PC4:PC5) Gen Ed SLO s: Critical Thinking, Information Literacy, Reading, Integrative Learning Unit - Older Adults Discuss the normal process of aging (C4) Discuss the common chronic diseases seen in older adults (C4) Explain the periodontal condition of older adults (C3, C4, HP2, HP4) Explain the caries pattern of older adults (C3, C4, HP2, HP4) Discuss the influence of medications on salivary flow (C3, C4) Discuss the dental hygiene treatment modifications that may be necessary for this population (C4; C10, PC1; PC2; PC3; PC4:PC5) Gen Ed SLO s: Critical Thinking, Information Literacy, Reading, Integrative Learning Unit - Patients with Bleeding Disorders Describe the following medial conditions: Hemophilia AlB, Von Witlebrands Disease, Sickle Cell Anemia, Iron Deficiency, Alcoholism (C4, HP, PC1; PC2; PC3; PC4: PC5) Discuss the etiologies of these conditions (C4) Explain the medical management for this population (C3, C4) Explain the types of mediations that these individuals are prescribed to manage their condition (C4) Discuss the dental hygiene treatment plan modifications that are necessary for each medical condition discussed in this unit (C4, C10, PC1; PC2; PC3; PC4:PC5) Gen Ed SLO s: Critical Thinking, Information Literacy, Reading, Integrative Learning 13